The New Science of Concussion and Mild Brain Injury in Children

Abstract

Concussions occur frequently in children and adolescents. Physicians are often faced with this common clinical problem and several decisions, such as when a patient needs to go to the emergency department or obtain additional imaging, must be made. Appropriate diagnosis and treatment is required to prevent post-concussive physical, cognitive, and emotional symptoms. Over the last decade there has been increasing attention and understanding of concussions. The purpose of this article is to provide a general review on literature regarding concussions in children and adolescents with a focus on (1) initial evaluation of concussion in children and adolescents; (2) decision-making guidelines for identifying children who are at very low risk of having a clinically significant injury and in whom neuroimaging can be avoided; (3) the use of assessment tools for baseline testing, diagnosis, and monitoring; (4) review of return-to-school and return-to-play guidelines; and (5) post-concussive symptoms and their management.